Bioflex crowns in pediatric dentistry: a scoping review of current evidence and clinical applications.

backgroundThis scoping review critically evaluates the clinical performance, retention, and aesthetic outcomes of Bioflex crowns in pediatric dentistry, addressing the inherent limitations of conventional stainless steel crowns (SSCs) and zirconia crowns. Conducted in accordance with PRISMA guidelines, the review synthesizes current evidence to determine the clinical viability of Bioflex crowns as an alternative option for full-coverage restorations in primary dentition.

methodsA total of six studies published between 2015 and 2025 were included following a comprehensive electronic search of PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar. The PICO framework guided the selection process: the population (P) consisted of children aged 3–8 years with primary teeth requiring restorations due to early childhood caries (ECC), pulpectomy, or aesthetic considerations; the intervention (I) was the use of Bioflex crowns; the comparators (C) were SSCs, zirconia, and strip crowns; and the outcomes (O) comprised clinical performance, retention, gingival health, and parental/child satisfaction. Sample sizes ranged from 1 to 75 participants or teeth, with follow-up durations of 1–12 months. Data were extracted into Microsoft Excel, and clinical assessments were performed using standardized indices such as the United States Public Health Service (USPHS) criteria, Likert scale, and Silness–Löe plaque and gingival indices.

resultsThe included studies reported favorable clinical outcomes for Bioflex crowns, demonstrating a 100% success rate following pulpectomy procedures and satisfactory retention and aesthetic results compared to control groups. The hybrid composition of Bioflex crowns contributed to improved adaptability and enhanced visual appeal, particularly in posterior molars. Nevertheless, zirconia crowns exhibited superior plaque control and gingival health scores (0.48 vs. 0.64 for SSCs at 12 months). No systemic or mechanical complications, such as hypersensitivity or crown fracture, were observed; however, occasional marginal adaptation discrepancies were documented. Substantial heterogeneity across crown designs, follow-up intervals, and evaluation criteria limited the ability to conduct direct quantitative comparisons. No quantitative comparative conclusions can be drawn due to heterogeneity and the preliminary nature of the evidence.

conclusionThis scoping review of six studies (2023–2025) suggests Bioflex crowns are a promising emerging option in pediatric dentistry, offering favorable aesthetics and adaptability in early reports. However, evidence is preliminary, limited by short follow-up (≤ 12 months), small samples, and mostly non-RCT designs, insufficient to establish equivalence or superiority over traditional crowns. Long-term RCTs are needed.